Provider Demographics
NPI:1831706373
Name:PLOCEK, ELENA (LCSWA)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:PLOCEK
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:PLOCEK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSWA
Mailing Address - Street 1:2617 FARTHING ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-4203
Mailing Address - Country:US
Mailing Address - Phone:352-727-1044
Mailing Address - Fax:
Practice Address - Street 1:2617 FARTHING ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-4203
Practice Address - Country:US
Practice Address - Phone:352-727-1044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0147571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical